How often do any of you use the Dual wave bolus on the pump? I am not sure if it is an option on all pumps, but we use the minimed Paradigm pump for Rory. I think it is most useful for meals that are higher in protein or fat that may cause delyed highs. For instance, when he eats mac&cheese he is usually really good 2 hours post meal like around 150, but then is high in the 300s 3 hours later. I am assuming the dual wave bolus might be effective for this and have yet to give it a try, I keep forgetting. Does anybody use it regularly for certain meals?
For Pizza - we almost always have pizza night on Fridays and we use an extended bolus (similar to the dual wave) We have the Animas Ping. I extend the bolus for 2 hours and give about 50-60% upfront and the rest is given over the remaining 2 hours. The nice thing about the extended bolus is that if I check in an hour and she has already come down to a good range I can stop the rest of the bolus . . .
Thanks, I will give that a try. Of course we are having pizza tonight and I wasn’t thinking and had my husband start his bolus as I was coming back with the pizza so we will have to try it next time.
I do use it for my niece but do not use it over many hours, as many people do. For pizza, I use 60/40 over two hours. If she becomes high later on, I increase the temp basal. This is because dual wave has backfired on us if given over four to six hour period. Lasagna, 1 and a half hours, 60/40. We don’t give other pasta, have switched to Quinoa pasta which does not need an extended bolus, digests pretty quickly. In fact, we have to give less insulin for Quinoa pasta. Tastes similar to regular pasta. For some reason with ice cream or potato chips, we do not need extended bolus for her. Duration of Action for Novolog is four and a half hours to five hours for her, and that may be unusual. If you forget to use the dual wave, you can use plus temp basal instead (it may even work better in some cases). If you do use the dual wave, you will have to experiment as every body is different. What works for us, probably will not work exactly the same for you.
We have just started using the Combo bolus (Animas term for square wave); we use it for high fat meals but I have to say we still haven’t gotten it completely down. Our CDE gave us a sliding scale of sorts: depending on his pre-meal blood sugar. For example if he is on target he gets the combo bolus in 50% upfront and then for Jim with pizza the other 50 in 2 hours. What we have found is different high fat foods have different peak times. There is one food we still haven’t got down and I would love suggestions: buttercream icing. We have thought about just not allowing him to have it but then what do you do at birthday, graduation, etc parties??
I would allow him to have the buttercream icing, since he probably does not have it every day. I’m guessing he has buttercream icing only occasionally? When having your own parties, I would switch to Carvel icecream cake, or another icecream cake. You can try it, if he likes it, and see how it works. Works great for us. I would think all the butter might slow down some of the sugar in that icing, but icing is going to be faster than the insulin. You could prebolus by 15 minutes. I have not found prebolusing all that helpful in DN’s case as it takes an hour and a half for Novolog to peak. I can actually see when it starts working on the cgms. At 1 hour and 20 minutes almost exactly is when I can see the sharper drops and that the insulin seems to be strongest. Buttercream icing is sure to spike before then. I say let him eat the cake and try to get him to run around a little.
i’ve only used a combo bolus about 3 times on my sons pump. when we had our animas rep come almost 2 years ago, we didn’t discuss it much. but by reading and researching it online, i think i’ve figured it out!
tonight we had pasta. ben is a just noodles and some parmesean kinda kid…we had some sort of whole wheat, extra fiber kind that came in a purple box…we’re at my sisters house visiting.
anyways, just from experieince, the pasta breaks down so slowly for ben and so i decided to try a combo bolus over 2 hours. it was 1.50 units. and i go about figuring that amount by entering the amounts in ezcarb, getting the total bolus and then back tracking to the combo bolus screen and enter the total there. is that correct?
when i put in the bolus it gave him 50% up front, 50% over the course of 2 hrs.
a serving size was 43 carbs.
from your experiences and knowledge, am i going about this the right way? i really would like to learn more about it so that i can use it more regularly.
any advice would be greatly appreciated!!!
My daughter has the Minimed and we use the dual wave when we have pizza. About 40% right away and 60% about an hour to an hour and a half later. My daughter usually goes low after pasta so we always carb for less for that. In fact last night we had pasta and I had her bolus for 30 for the pasta instead of the 42 and an hour and a half later she was feeling low and was 54! Most of the time it doesn’t make her go low that far.